FUNCTIONAL ACTIVITY OF NEUTROPHIL GRANULOCYTES AS AN EARLY MARKER OF INFECTIOUS INFLAMMATION IN ACUTE PANCREATITIS

Abstract

It is known that acute pancreatitis is initially an aseptic inflammation of the pancreas. Emergency patients with acute pancreatitis have both concomitant and/or pancreas-associated foci of infection. Neutrophilic granulocytes are immediately responding effectors of acute inflammation, and their response to aseptic or infectious inflammation may be different. In order to determine the functional characteristics of neutrophilic granulocytes as early markers of the infectious process in acute pancreatitis, the course of the disease was analyzed in 95 patients admitted to the City Pancreatology Center of the State Budgetary Institution of St. Petersburg Research Institute of Emergency Care named after I.I. Dzhanelidze with a diagnosis of acute pancreatitis in 2022-2024, aged 20-80 years, the time from the first symptoms of the disease is no more than 48 hours. The severity of acute pancreatitis was determined using the rapid assessment scale for the severity of acute pancreatitis of the St. Petersburg Research Institute of Emergency Care named after I.I. Dzhanelidze, distinguishing between mild, moderate and severe degrees. Venous blood was examined on days 1, 3 and 10 from the moment of hospitalization. The number of neutrophilic granulocytes and the granulocyte reactivity index were estimated using flow cytometry, the absolute number of CD14⁺ neutrophils, the content of soluble CD14 receptors and the antimicrobial peptide of granulocytes - soluble α-defensin in the serum. Additionally, the content of the systemic inflammation marker interleukin-6 and bacterial infection marker procalcitonin in the blood was analyzed. Statistical analysis was performed using the StatTech v.4.6.1 program. Local or systemic infectious processes were observed in 57% of patients with acute pancreatitis, ranging from 28% in the edematous form to 83% in the severe form. Three indicators were identified as early markers of bacterial infection in acute pancreatitis: neutrophil granulocyte reactivity, soluble CD14, and soluble defensin.